Childtime Learning Center 1002

8VAC20-780-340-A Complaint related: Yes

“When staff are supervising children, they shall always ensure their care and protection. The two-year class was combined with the three-year old class for three days the week of 01/05/2026. Staff report this disrupted the routine and overall safety of children in care as they could not implement planned activities due to the developmental difference between the age groups. Additionally, staff report the three-year old children were shoving and hitting the two-year old children and one child in the group has behavior challenges they did not feel sufficiently trained to handle with the addition of the younger children.”

8VAC20-780-370-5 Complaint related: Yes

“Infants shall be protected from older children. Multiple staff report that infants have not been protected from toddlers when the groups are combined in the early morning. Multiple staff report incidents of toddlers sitting on, tripping over and hitting infants.”

8VAC20-780-500-B Complaint related: Yes

“For children younger than three years, diapers shall be changed on a changing table or countertop designed for changing. Staff reported that two-year old children's diapers were changed, in the bathroom with the children standing up, for three days the week of 01/05/2026. The two-year old children were being cared for in the three-year old classroom which lacks a diaper changing table.”

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain all required elements. The enrollment record for child 1 lacked the following required information: a work phone number for each parent and the name, address and phone number of a second emergency contact.”

8VAC20-780-70

“Staff records shall contain all required elements. 1. Staff 1 lacked documentation of two references as to character and reputation as well as competency were checked before employment. Staff 1 has been employed for more than 30 days. 2. Documentation to demonstrate that staff 2 had completed orientation training within 7 days of assuming job responsibilities was not on file. Staff 2 has been employed for more than 90 days.”

8VAC20-780-140-A

“Each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Child 1 lacked documentation of a physical exam. Child 1 has been in care for more than 80 days.”

8VAC20-780-500-B

“Disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. A wet diaper was observed on the floor of the two-year old bathroom.”

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain all required elements. The enrollment record for child 1 lacked the following required information: a work phone number for each parent and the name, address and phone number of a second emergency contact.”

8VAC20-780-70

“Staff records shall contain all required elements. 1. Staff 1 lacked documentation of two references as to character and reputation as well as competency were checked before employment. Staff 1 has been employed for more than 30 days. 2. Documentation to demonstrate that staff 2 had completed orientation training within 7 days of assuming job responsibilities was not on file. Staff 2 has been employed for more than 90 days.”

8VAC20-780-140-A

“Each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Child 1 lacked documentation of a physical exam. Child 1 has been in care for more than 80 days.”

8VAC20-780-500-B

“Disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. A wet diaper was observed on the floor of the two-year old bathroom.”

8VAC20-780-40-E

“The operational responsibilities of the licensee shall include ensuring that the center's activities, services, and facilities are maintained in compliance with these standards and the center's own policies and procedures that are required by these standards. 1. Staff 1 did not follow center policy when she picked up child 1 by both wrists on 11/03/2025 at approximately 9:09 am. Written center policy states that "Lifting a child up by hands or wrists" is a behavior to avoid." a. Staff 1 confirmed she failed to follow center policy for lifting children.”

8VAC20-780-340-A

“When staff are supervising children, they shall always ensure their care and protection. At approximately 9:09 am on 11/03/2025, staff 1 lifted child 1, age 2 years, up by both wrists causing an injury that required medical attention. Staff 1 stated the child 1 was crying and holding her right arm after being picked up.”

8VAC20-780-530-A-2

“At least one staff in each classroom or area where children are present shall have current certification in first aid from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council. Staff 1, who was alone with a group of children on 11/03/2025 at approximately 9:09 am, did not have first aid certification from an approved organization.”

8VAC20-780-530-A-1

“At least one staff in each classroom or area where children are present shall have current certification in cardiopulmonary resuscitation (CPR) as appropriate to the age of the children in care from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council. The training shall include an in-person competency demonstration. The CPR certification obtained by staff 1 was not from an approved organization and did not include an in-person competency demonstration. Staff 1 was alone with a group of children on 11/03/2025 at approximately 9:09 am.”

8VAC20-780-180-A Complaint related: No

“Staff shall be capable of carrying out assigned responsibilities. During observation of the infant classroom on 11/05/2025 and 11/07/2025 staff 1 could not meet the requirements of the job description for a teacher which requires lifting, carrying, kneeling, squatting, standing, balancing and pulling. Staff 1 was observed sitting in a chair while feeding infants placed in highchairs by other staff present. Staff 1 also cleaned and sanitized the highchair trays with cleaning products that had to be brought to her by the other staff. Staff 1 stated she was only able to sit in a chair and feed children or perform duties from a seated position as she did not have the ability to stand, lift, kneel, squat or pickup a child.”

8VAC20-780-570-D Complaint related: Yes

“Infants shall be fed in accordance with parental instructions. Child 1, age 12 months, was not fed according to written parental instructions which stated that a bottle was to be given every 2 hours. Child 1 arrived at 8:27 am on 10/31/2025 with 4 bottles provided by the parent. Child 1 received the first bottle at 2:51 pm.”

8VAC20-780-340-F Complaint related: No

“Children under 10 years of age always shall be within actual sight and sound supervision of staff, On 11/05/2025 child 2, age 7 months, was twice placed on the floor of the infant classroom in a back corner area that staff could not see due to the placement of a second diaper changing table, blocking sight lines. The 4 staff present were caring for infants in the front area of the classroom and additionally could not hear child 2 due to multiple crying infants that were in care in the front area of the classroom.”

8VAC20-780-370-4 Complaint related: Yes

“During the day, infants shall be provided with comfort as needed. The center failed to offer comfort to 3 infants between 11:18 am - 11:50 am on 11/05/2025 who had multiple episodes of crying lasting from 3 - 10 minutes each while placed in a crib and on the floor. The 4 staff present did not hold, talk to or acknowledge child 2, child 3 and child 4 who were between the ages of 5 months - 9 months.”

8VAC20-780-420-E-1 Complaint related: Yes

“For each infant, the center shall post a daily record which shall contain the amount of food consumed and the time. The infant daily record for child 1 did not list a snack that was fed, according to staff, to child 1 at approximately 11:30 am on 10/31/2025.”

8VAC20-780-180-A Complaint related: No

“Staff shall be capable of carrying out assigned responsibilities. During observation of the infant classroom on 11/05/2025 and 11/07/2025 staff 1 could not meet the requirements of the job description for a teacher which requires lifting, carrying, kneeling, squatting, standing, balancing and pulling. Staff 1 was observed sitting in a chair while feeding infants placed in highchairs by other staff present. Staff 1 also cleaned and sanitized the highchair trays with cleaning products that had to be brought to her by the other staff. Staff 1 stated she was only able to sit in a chair and feed children or perform duties from a seated position as she did not have the ability to stand, lift, kneel, squat or pickup a child.”

8VAC20-780-570-D Complaint related: Yes

“Infants shall be fed in accordance with parental instructions. Child 1, age 12 months, was not fed according to written parental instructions which stated that a bottle was to be given every 2 hours. Child 1 arrived at 8:27 am on 10/31/2025 with 4 bottles provided by the parent. Child 1 received the first bottle at 2:51 pm.”

8VAC20-780-340-F Complaint related: No

“Children under 10 years of age always shall be within actual sight and sound supervision of staff, On 11/05/2025 child 2, age 7 months, was twice placed on the floor of the infant classroom in a back corner area that staff could not see due to the placement of a second diaper changing table, blocking sight lines. The 4 staff present were caring for infants in the front area of the classroom and additionally could not hear child 2 due to multiple crying infants that were in care in the front area of the classroom.”

8VAC20-780-370-4 Complaint related: Yes

“During the day, infants shall be provided with comfort as needed. The center failed to offer comfort to 3 infants between 11:18 am - 11:50 am on 11/05/2025 who had multiple episodes of crying lasting from 3 - 10 minutes each while placed in a crib and on the floor. The 4 staff present did not hold, talk to or acknowledge child 2, child 3 and child 4 who were between the ages of 5 months - 9 months.”

8VAC20-780-420-E-1 Complaint related: Yes

“For each infant, the center shall post a daily record which shall contain the amount of food consumed and the time. The infant daily record for child 1 did not list a snack that was fed, according to staff, to child 1 at approximately 11:30 am on 10/31/2025.”

8VAC20-780-340-F Complaint related: Yes

“Children under 10 years of age always shall be within actual sight supervision of staff. Staff 1, who was alone and responsible for supervising the two-year old classroom, stated she was not aware, nor did she see, child 1 and child 2 running around the perimeter of the classroom while pushing wooden cars from a standing position or that child 1 had fallen, until she heard child 1 crying. Staff 1 had her back to the children and was cleaning up the home living area of the classroom when the car that child 1 was pushing suddenly stopped causing child 1 to fall forward and begin to cry. Child 1 sustained an injury to the mouth that later required medical attention.”

8VAC20-780-340-A Complaint related: Yes

“When staff are supervising children, they shall always ensure their care, protection, and guidance. Staff 1, who was alone and responsible for supervising the two-year old classroom, did not intervene or redirect 2 children who were running around the classroom while pushing a wooden toy car that was intended for use in block play. The way that child 1 was using the car caused her to fall and sustain an injury that resulted in bleeding around her mouth requiring medical treatment.”

8VAC20-780-550-P Complaint related: Yes

“The center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include all required elements, including two signatures - either a staff and parent or two staff members. The second signature (the parent's) on an injury report form written on 09/22/2025 was not recorded on the form until 09/23/2025.”

8VAC20-780-340-F Complaint related: Yes

“Children under 10 years of age always shall be within actual sight supervision of staff. Staff 1, who was alone and responsible for supervising the two-year old classroom, stated she was not aware, nor did she see, child 1 and child 2 running around the perimeter of the classroom while pushing wooden cars from a standing position or that child 1 had fallen, until she heard child 1 crying. Staff 1 had her back to the children and was cleaning up the home living area of the classroom when the car that child 1 was pushing suddenly stopped causing child 1 to fall forward and begin to cry. Child 1 sustained an injury to the mouth that later required medical attention.”

8VAC20-780-340-A Complaint related: Yes

“When staff are supervising children, they shall always ensure their care, protection, and guidance. Staff 1, who was alone and responsible for supervising the two-year old classroom, did not intervene or redirect 2 children who were running around the classroom while pushing a wooden toy car that was intended for use in block play. The way that child 1 was using the car caused her to fall and sustain an injury that resulted in bleeding around her mouth requiring medical treatment.”

8VAC20-780-550-P Complaint related: Yes

“The center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include all required elements, including two signatures - either a staff and parent or two staff members. The second signature (the parent's) on an injury report form written on 09/22/2025 was not recorded on the form until 09/23/2025.”

8VAC20-780-340-A Complaint related: Yes

“When staff are supervising children, they shall always ensure their care and protection. 1. Staff 1 fell asleep, twice, while holding an 8 month old infant in a rocking chair for approximately 6 minutes on 08/20/2025. 2. Staff 2 and staff 3 stated that staff 1 had told them she was tired and needed to go home. When they realized she had fallen asleep with an infant in her arms, they did not intervene immediately to ensure the safety of the infant, or notify management until staff 1 had fallen asleep a second time.”

8VAC20-780-270-D Complaint related: Yes

“Fans or other cooling systems shall be used when the temperature of inside areas occupied by children exceeds 80?F. The temperature in two classrooms measured between 81 and 83 degrees at 2:05 pm on 06/23/2025. No fans or cooling systems were in use in these two classrooms.”

8VAC20-780-400-A Complaint related: Yes

“In order to promote the child's emotional, and social well-being, staff shall interact with the child and one another to provide needed help, comfort and support. Staff 1 used loud and inappropriate language while interacting with other staff during a shelter-in-place practice drill on the morning of 04/22/2025 while children were present in their care.”

8VAC20-780-410-1 Complaint related: Yes

“The following actions are forbidden: roughly handling a child. Multiple staff stated that staff 1 roughly handled child 1, age 6 months, by sitting the crying child on the floor and the child fell back and hit his head on the floor.”

8VAC20-780-270-A Complaint related: Yes

“Areas and equipment of the center shall be maintained in a clean, safe and operable condition. 1. The bathroom used for shelter-in-place practice drills was stacked with stored equipment in such a way that 6 staff and 10 infants could not safely enter the space during a practice drill on 4/22/2025. Multiple staff referred to the bathroom as a storage space, stated there was not enough space for children and staff and, that the space was not prepared for emergency drills. 2. Children's access to toilets and sinks in the infant/toddler bathroom was blocked due to multiple items being stored/stacked in the bathroom. 3. Two of the toilets inside of the infant/toddler bathroom were not clean as they contained a black substance, toilet paper and clothing floating in the toilet bowl.”

8VAC20-780-400-A Complaint related: No

“In order to promote the child’s physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort and support. At the conclusion of nap, on 09/11/2024, staff 1 removed child 1, who was not fully awake, from the cot by lifting the cot and rolling the child onto the floor. Staff 1 throws the sheet on top of child 1 leaving child 1 laying on the floor. Staff 1 returns and abruptly grabs the sheet and blanket off child 1 who remains on the floor still not fully awake. Other staff report that staff 1 routinely speaks to children in ways that do not promote needed help, comfort and support.”

8VAC20-780-270-A

“Repeat Violation Areas and equipment of the center shall be maintained in a safe condition. 1. The top half of the dutch door in the bathroom of the two-year old classroom and the three-year old classroom was open when both classrooms were reviewed. a.The top half of the door was not securely latched to prevent the door from swinging back and forth. b. Unsecured dutch doors are a pinch point safety hazard.”

22.1-289.035-B-4

“Repeat Violation The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #1, employed for 75 days, did not have documentation of requesting a central registry check from one state. Staff #2, employed for 13 months, did not have documentation of the results of a central registry check from one state.”

8VAC20-780-400-A Complaint related: No

“In order to promote the child’s physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort and support. At the conclusion of nap, on 09/11/2024, staff 1 removed child 1, who was not fully awake, from the cot by lifting the cot and rolling the child onto the floor. Staff 1 throws the sheet on top of child 1 leaving child 1 laying on the floor. Staff 1 returns and abruptly grabs the sheet and blanket off child 1 who remains on the floor still not fully awake. Other staff report that staff 1 routinely speaks to children in ways that do not promote needed help, comfort and support.”

8VAC20-780-270-A

“Repeat Violation Areas and equipment of the center shall be maintained in a safe condition. 1. The top half of the dutch door in the bathroom of the two-year old classroom and the three-year old classroom was open when both classrooms were reviewed. a.The top half of the door was not securely latched to prevent the door from swinging back and forth. b. Unsecured dutch doors are a pinch point safety hazard.”

22.1-289.035-B-4

“Repeat Violation The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #1, employed for 75 days, did not have documentation of requesting a central registry check from one state. Staff #2, employed for 13 months, did not have documentation of the results of a central registry check from one state.”

22.1-289.035-B-4

“Based on record review and staff interview, the center failed to obtain a copy of the results of a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1, hire date 07/24/2023, lacks the results of a central registry check for another state of residence within the past five years. 2. Administrative staff confirmed that the results of a central registry check had not been received.”

8VAC20-780-140-A

“Based on record review, the center failed to obtain documentation that each child has had a physical examination by or under the direction of a physician before attendance or within one month after attendance. Evidence: 1. Child 2, enrollment date 03/18/2024 lacks documentation of a physical exam. 2. Administrative staff confirmed the results of a physical exam were not on file for child 2.”

8VAC20-780-200-A

“Based on record review, the center failed to have a qualified program director who meets one of the director qualifications who shall regularly be on site at least 50% of the center's hours of operation. Evidence: 1. The educational credentials provided do not indicate sufficient documentation to confirm that staff 2 meets program director qualifications outlined in standard 210.A a. Administrative staff confirmed that staff 2 does not have all of the required educational credentials for the program director position. 2. Staff 2 has been functioning in the program director position since 08/28/2023. b. Staff 2 is listed as the program director on the renewal application.”

8VAC20-780-260-B

“Based on staff interview, the center failed to obtain for the facility annual approval from the health department. Evidence: 1. Administrative staff stated an annual inspection had not been conducted by the Virginia Beach Health Department in 2023 or 2024.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas of the center shall be maintained in a safe condition. Evidence: 1. The top half of the "Dutch" door in the two-year classroom bathroom was open at the top. a. The top half of the door was not securely latched to prevent the door from swinging back and forth. b. Unsecured Dutch doors are a pinch point safety hazard.”

8VAC20-780-340-F

“Repeat Violation Based on staff interviews, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. Center administrative staff, staff 2 and staff 3, reported to the inspector that the gate between the two outdoor play areas was left open on 04/29/2024 at approximately 10:00 am resulting in 6 children from the two-year old class wandering over to the toddler playground without knowledge of the two staff responsible for their supervision. a. Administrative stated that the toddler playground was not within sight and sound supervision of the area of the preschool outdoor play area where staff were standing. b. Administrative staff confirmed that the 6 children were unsupervised on the toddler playground for approximately 10 minutes based on a review of center video.”

8VAC20-780-510-G

“Based on medication review, the center failed to ensure that medication shall be labeled with the child's name. Evidence: One prescription medication was not labeled with the child's name.”

8VAC20-780-510-I

“Based on medication review and interview, the center failed to ensure that prescription medication shall be maintained in the original, labeled container. Evidence: 1. One prescription medication for child 1 was not stored in the original medication box with prescription affixed label. 2. Administrative staff confirmed that this medication was received without the medication box and prescription label.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Child 3, enrollment date 05/15/2023, lacks documentation of required immunizations. 2. Child 4, enrollment date 08/09/2023, lacks documentation of required immunizations. 3. Both children were in care during the inspection and administrative staff confirmed the immunization documentation was not on file in the enrollment record.”

22.1-289.035-B-4

“Based on record review and staff interview, the center failed to obtain a copy of the results of a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1, hire date 07/24/2023, lacks the results of a central registry check for another state of residence within the past five years. 2. Administrative staff confirmed that the results of a central registry check had not been received.”

8VAC20-780-140-A

“Based on record review, the center failed to obtain documentation that each child has had a physical examination by or under the direction of a physician before attendance or within one month after attendance. Evidence: 1. Child 2, enrollment date 03/18/2024 lacks documentation of a physical exam. 2. Administrative staff confirmed the results of a physical exam were not on file for child 2.”

8VAC20-780-200-A

“Based on record review, the center failed to have a qualified program director who meets one of the director qualifications who shall regularly be on site at least 50% of the center's hours of operation. Evidence: 1. The educational credentials provided do not indicate sufficient documentation to confirm that staff 2 meets program director qualifications outlined in standard 210.A a. Administrative staff confirmed that staff 2 does not have all of the required educational credentials for the program director position. 2. Staff 2 has been functioning in the program director position since 08/28/2023. b. Staff 2 is listed as the program director on the renewal application.”

8VAC20-780-260-B

“Based on staff interview, the center failed to obtain for the facility annual approval from the health department. Evidence: 1. Administrative staff stated an annual inspection had not been conducted by the Virginia Beach Health Department in 2023 or 2024.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas of the center shall be maintained in a safe condition. Evidence: 1. The top half of the "Dutch" door in the two-year classroom bathroom was open at the top. a. The top half of the door was not securely latched to prevent the door from swinging back and forth. b. Unsecured Dutch doors are a pinch point safety hazard.”

8VAC20-780-340-F

“Repeat Violation Based on staff interviews, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. Center administrative staff, staff 2 and staff 3, reported to the inspector that the gate between the two outdoor play areas was left open on 04/29/2024 at approximately 10:00 am resulting in 6 children from the two-year old class wandering over to the toddler playground without knowledge of the two staff responsible for their supervision. a. Administrative stated that the toddler playground was not within sight and sound supervision of the area of the preschool outdoor play area where staff were standing. b. Administrative staff confirmed that the 6 children were unsupervised on the toddler playground for approximately 10 minutes based on a review of center video.”

8VAC20-780-510-G

“Based on medication review, the center failed to ensure that medication shall be labeled with the child's name. Evidence: One prescription medication was not labeled with the child's name.”

8VAC20-780-510-I

“Based on medication review and interview, the center failed to ensure that prescription medication shall be maintained in the original, labeled container. Evidence: 1. One prescription medication for child 1 was not stored in the original medication box with prescription affixed label. 2. Administrative staff confirmed that this medication was received without the medication box and prescription label.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Child 3, enrollment date 05/15/2023, lacks documentation of required immunizations. 2. Child 4, enrollment date 08/09/2023, lacks documentation of required immunizations. 3. Both children were in care during the inspection and administrative staff confirmed the immunization documentation was not on file in the enrollment record.”

8VAC20-780-550-P Complaint related: Yes

“Based on record review, the center failed to ensure that the written record of children's serious injuries in which entries are made the day of occurrence lacked all of the required elements. Evidence: 1. A review of more than 100 injury reports from 12/02/2023 through 03/17/2024 found the following required documentation lacking in written injury reports: a. 27 lacked either a parent or second staff signature; b. 69 lacked documentation of the time and method of parent notification; c. 16 lacked documentation or a staff and parent signature or 2 staff signatures; d. All of the injury reports reviewed lacked any documentation of how to prevent recurrence of the injury.”

8VAC20-780-340-A Complaint related: Yes

“Based on staff interviews, observations and a review of center video and injury reports, the center failed to ensure the care and protection of children. Evidence: 1. A review of injury reports for the two-year old classroom indicated approximately 122 injuries from approximately 12/02/2023 - 03/12/2024. a. 60 of these injuries were of children being bitten by another child; b. 39 of these injuries were of children being scratched, pushed or hit by toys thrown by another child. 2. Center staff interviewed, staff 1, staff 2, staff 3 and staff 4 described the two-year old classroom as "lacking structure," "chaotic," and difficult to manage. a. Staff additionally indicated that they did not feel they had the training or skills needed to manage children's behavior challenges especially biting. b. Staff also stated there were multiple children in the classroom with identified behavior challenges nevertheless, they had not received any training specific to these children or been apprised of any plan in place to address the behavior challenges. 3. A review of center video in the two-year old classroom, from approximately 8:10 am - 8:20 am on 03/08/2024, showed multiple incidents of children being injured by other children. a. One child was observed throwing toys while a second child hit another child. b. The video also showed ten children roaming around the room, climbing over overturned chairs, and attempting to climb up the diaper changing table while the two staff responsible for supervising the classroom of twelve children were occupied as they were assisting the other two children during this time. c. The lack of available activities and supervision for the ten children, resulted in the children occupying themselves in activities that increased the risk of injury. 4. During a classroom observation on 03/15/2024 child 1, who has been identified by all staff in addition to written records as having behavior challenges, bit another child while playing by the cots at approximately 11:10 am. a. During a planned activity, child 1 was not being supervised closely by staff which resulted in a "crowding" situation near the cots where child 1 was able to bite child 2.”

8VAC20-780-240-A

“Based on record review and interview, the center failed to ensure that staff complete The Virginia Department of Education-sponsored orientation course within 90 calendar days of employment. 1. Staff 2, hire date 11/13/2023, lacks documentation of completion of The Virginia Department of Education sponsored orientation course. 2. The program director confirmed that a certificate was not on file to demonstrate that staff 2 had completed this training.”

8VAC20-780-90-A

“Based on record review and interview, the center failed to ensure that a written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent and shall include authorization for emergency medical care, pick up of ill child and notification of communicable disease. Evidence: 1. The written parent agreement was not on file in the enrollment record of child 4. 2. The program director confirmed that a parent agreement was not on file for child 4.”

8VAC20-780-70

“Based on record review and interview, the center failed to ensure that staff records contain all required elements: Evidence: 1. The record for staff 1, hire date 04/17/2023, lacked the following required information: a. The name, address and phone number of a person to be notified in an emergency; b. Documentation that two or more references as to character and reputation as well as competency were checked before employment. c. Staff 1 was present and working in the facility during the inspection. 2. The record for staff 2, hire date 11/13/2023, lacked documentation of orientation training required by 8VAC20-780-240.B . 3. The record for staff 3, hire date 01/02/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. a. The name, address and telephone number of a person to be notified in an emergency was not on file for staff 3. b. Documentation to demonstrate that staff 3 possesses the education required by her job title of program leader was not on file. c. Staff 3 was present and working in the facility during the inspection. 4. The record for staff 4, hire date 01/15/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. 5. The program director confirmed that the above documents/documentation was not on file.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure that children's records contain all required documents. Evidence: 1. The enrollment record for child 1 lacked the following required information: a. Phone number for child's physician; b. An address for the second emergency contact. 2. The enrollment record for child 2 lacked the registration form containing all required elements. a. The program director confirmed that a completed enrollment form was not available for child 2. b. The program director stated that child 2 had an enrollment date of 08/03/2023. 3. The enrollment record for child 3 lacked the following required information: a. The work phone number for each parent's place of employment; b. An address and phone number for the second designated emergency contact. 4. The enrollment record for child 4, enrollment date 08/05/2021, lacked documentation of verification of age and identity. 5. The program director (staff 1 )confirmed the above documentation was missing from the records of child 1, 2 , 3 and 4.”

8VAC20-780-40-M

“Based on classroom review and interview, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list shall be dated and kept confidential in each room or area where children are present. Evidence: 1. The list of all children's allergies, sensitivities, and dietary restrictions was not maintained in the three-year old classroom. a. The allergy list in the classroom listed, "none" however, there are children in attendance, in other classrooms, with allergies, sensitivities and dietary restrictions. 2. The allergy list in the four-year old classroom only listed allergies, sensitivities, and dietary restrictions for children in attendance for the four-year old class. 3. The program director verified that classroom allergy lists only noted allergies, sensitivities and dietary restrictions for children in the individual class rather then the entire school.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 5, enrollment date 09/25/2023, lacked documentation of the required physical exam. 2. The program director confirmed that a physical exam was not on file for child 5.”

8VAC20-780-130-A

“Based on record review and interview, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Child 5, enrollment date 09/25/2023, did not have documentation of immunizations required by the State Board of Health. a. Child 5 was in care during the inspection. 2. The program director confirmed that an immunization record was not on file for child 5.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean and safe condition. Evidence: 1. The bathroom between the two-year old classroom and three-year old classroom was not maintained in a clean and safe condition as demonstrated by the following: a. Three wet pull-ups, used wipes, and crumbled toilet paper was observed on the floor of the two-year old & three- year old bathroom at approximately 10:00 am on 02/27/2024. b. The inspector additionally observed a dry pull up, package of wipes, toilet plunger, toilet brush cleaner and a small toy were also lying on the floor near the toilet and children's hand washing sink in this bathroom. The placement of these items is a trip hazard as they are in space utilized for access to both the toilet and sink. c. The staff in the two-year old classroom, three-year old classroom and the program director all stated they were not aware that the wet pull-ups, wipes, toilet paper and other items had been left on the floor of the bathroom. 2. There are three exposed tree roots, beside the side walk , on the infant/toddler playground. These exposed tree roots are a trip hazard.”

8VAC20-780-290-A-3

“Based on observation, the center failed to ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: 1. One outlet in the three-year old classroom, near the large motor area, lacked a protective cover. 2. Three outlets in the two-year old class, near the bathroom, back door and front door, lacked a protective cover. 3. One outlet in the toddler classroom, near the back door, lacked a protective cover.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that when diapering of children disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot -operated and that the diapering surface shall be sanitized after each use for diapering. "Sanitized" means the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions. Evidence: 1. The surface of the diaper changing table, in the two-year old classroom, was not allowed to air dry after two diaper changes on 02/27/2024 at approximately 10:10 am. a. The surface was immediately wiped with a wet wipe after the disinfectant was sprayed. 2. Three wet disposable pull-ups were observed on the floor of the bathroom located between the two-year old and three-year old classroom on 02/27/2024 at approximately 10:00 am.”

8VAC20-780-570-C

“Based on record review and interview, the center failed to ensure that the record of each child on formula shall contain the brand of formula and the child's feeding schedule. Evidence: 1. Written documentation of the brand of formula and feeding schedule was not available for child 1, child 2 and child 3. a. Child 1, 2 and 3 were in care during the inspection on 02/27/2023 and are bottle fed. 2. Infant staff confirmed that a written feeding schedule and brand of formula was not on file.”

8VAC20-780-580-B

“Based on observation and interview, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the safety standards set by the Department of Motor Vehicles. Evidence: 1. The facility bus used to drop off and pick up children from public school lacked a current vehicle registration. The sticker on the attached license plates indicated the registration expired August 2023. 2. The program director stated she did not have a current registration sticker or certificate for the facility bus in use during the inspection on 02/27/2024 and 03/01/2024.”

8VAC20-820-120-E-6

“Based on observation, the center failed to ensure that a copy of any special order issued by the department shall be posted in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The special order issued on 11/16/2023 was not posted in a prominent place at each public entrance of the licensed premises on 02/27/2024. 2. The program director confirmed that the special order issued on 11/16/2023 was not posted.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to obtain a central registry finding within 30 days of employment for staff. Evidence: 1. Staff 2, hire date 11/13/2023, lacks the results of a central registry finding. a. Written documentation provided indicated that the request had been returned to the facility on 01/22/2024 for additional information. b. There was no documentation that the request had been re-submitted. 2. The program director stated she was not aware that the central registry finding was not on file nor was she aware that the request had been returned for additional information until she pulled the file for review by the inspector on 02/27/2024.”

22.1-289.011-F

“Based on observation and interview, the center failed to ensure that the findings of the most recent inspection shall be posted in a conspicuous place on the licensed premises. Evidence: 1. The findings from the most recent inspection, conducted on 09/05/2023, were not posted. a. The findings from the 07/23/2023 were posted. 2. The program director confirmed that the findings from the 09/05/2023 monitoring inspection were not posted.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment. Evidence: 1. Staff 3, hire date 01/02/2024, does not have documentation of a tuberculosis screening. a. Staff 3 was present and working during the inspection. 2. Staff 4, hire date 01/15/2024, does not have documentation of a tuberculosis screening. 3. The program director confirmed that documentation of a TB screening was not available for staff 3 and staff 4.”

8VAC20-780-550-P Complaint related: Yes

“Based on record review, the center failed to ensure that the written record of children's serious injuries in which entries are made the day of occurrence lacked all of the required elements. Evidence: 1. A review of more than 100 injury reports from 12/02/2023 through 03/17/2024 found the following required documentation lacking in written injury reports: a. 27 lacked either a parent or second staff signature; b. 69 lacked documentation of the time and method of parent notification; c. 16 lacked documentation or a staff and parent signature or 2 staff signatures; d. All of the injury reports reviewed lacked any documentation of how to prevent recurrence of the injury.”

8VAC20-780-340-A Complaint related: Yes

“Based on staff interviews, observations and a review of center video and injury reports, the center failed to ensure the care and protection of children. Evidence: 1. A review of injury reports for the two-year old classroom indicated approximately 122 injuries from approximately 12/02/2023 - 03/12/2024. a. 60 of these injuries were of children being bitten by another child; b. 39 of these injuries were of children being scratched, pushed or hit by toys thrown by another child. 2. Center staff interviewed, staff 1, staff 2, staff 3 and staff 4 described the two-year old classroom as "lacking structure," "chaotic," and difficult to manage. a. Staff additionally indicated that they did not feel they had the training or skills needed to manage children's behavior challenges especially biting. b. Staff also stated there were multiple children in the classroom with identified behavior challenges nevertheless, they had not received any training specific to these children or been apprised of any plan in place to address the behavior challenges. 3. A review of center video in the two-year old classroom, from approximately 8:10 am - 8:20 am on 03/08/2024, showed multiple incidents of children being injured by other children. a. One child was observed throwing toys while a second child hit another child. b. The video also showed ten children roaming around the room, climbing over overturned chairs, and attempting to climb up the diaper changing table while the two staff responsible for supervising the classroom of twelve children were occupied as they were assisting the other two children during this time. c. The lack of available activities and supervision for the ten children, resulted in the children occupying themselves in activities that increased the risk of injury. 4. During a classroom observation on 03/15/2024 child 1, who has been identified by all staff in addition to written records as having behavior challenges, bit another child while playing by the cots at approximately 11:10 am. a. During a planned activity, child 1 was not being supervised closely by staff which resulted in a "crowding" situation near the cots where child 1 was able to bite child 2.”

8VAC20-780-240-A

“Based on record review and interview, the center failed to ensure that staff complete The Virginia Department of Education-sponsored orientation course within 90 calendar days of employment. 1. Staff 2, hire date 11/13/2023, lacks documentation of completion of The Virginia Department of Education sponsored orientation course. 2. The program director confirmed that a certificate was not on file to demonstrate that staff 2 had completed this training.”

8VAC20-780-90-A

“Based on record review and interview, the center failed to ensure that a written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent and shall include authorization for emergency medical care, pick up of ill child and notification of communicable disease. Evidence: 1. The written parent agreement was not on file in the enrollment record of child 4. 2. The program director confirmed that a parent agreement was not on file for child 4.”

8VAC20-780-70

“Based on record review and interview, the center failed to ensure that staff records contain all required elements: Evidence: 1. The record for staff 1, hire date 04/17/2023, lacked the following required information: a. The name, address and phone number of a person to be notified in an emergency; b. Documentation that two or more references as to character and reputation as well as competency were checked before employment. c. Staff 1 was present and working in the facility during the inspection. 2. The record for staff 2, hire date 11/13/2023, lacked documentation of orientation training required by 8VAC20-780-240.B . 3. The record for staff 3, hire date 01/02/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. a. The name, address and telephone number of a person to be notified in an emergency was not on file for staff 3. b. Documentation to demonstrate that staff 3 possesses the education required by her job title of program leader was not on file. c. Staff 3 was present and working in the facility during the inspection. 4. The record for staff 4, hire date 01/15/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. 5. The program director confirmed that the above documents/documentation was not on file.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure that children's records contain all required documents. Evidence: 1. The enrollment record for child 1 lacked the following required information: a. Phone number for child's physician; b. An address for the second emergency contact. 2. The enrollment record for child 2 lacked the registration form containing all required elements. a. The program director confirmed that a completed enrollment form was not available for child 2. b. The program director stated that child 2 had an enrollment date of 08/03/2023. 3. The enrollment record for child 3 lacked the following required information: a. The work phone number for each parent's place of employment; b. An address and phone number for the second designated emergency contact. 4. The enrollment record for child 4, enrollment date 08/05/2021, lacked documentation of verification of age and identity. 5. The program director (staff 1 )confirmed the above documentation was missing from the records of child 1, 2 , 3 and 4.”

8VAC20-780-40-M

“Based on classroom review and interview, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list shall be dated and kept confidential in each room or area where children are present. Evidence: 1. The list of all children's allergies, sensitivities, and dietary restrictions was not maintained in the three-year old classroom. a. The allergy list in the classroom listed, "none" however, there are children in attendance, in other classrooms, with allergies, sensitivities and dietary restrictions. 2. The allergy list in the four-year old classroom only listed allergies, sensitivities, and dietary restrictions for children in attendance for the four-year old class. 3. The program director verified that classroom allergy lists only noted allergies, sensitivities and dietary restrictions for children in the individual class rather then the entire school.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 5, enrollment date 09/25/2023, lacked documentation of the required physical exam. 2. The program director confirmed that a physical exam was not on file for child 5.”

8VAC20-780-130-A

“Based on record review and interview, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Child 5, enrollment date 09/25/2023, did not have documentation of immunizations required by the State Board of Health. a. Child 5 was in care during the inspection. 2. The program director confirmed that an immunization record was not on file for child 5.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean and safe condition. Evidence: 1. The bathroom between the two-year old classroom and three-year old classroom was not maintained in a clean and safe condition as demonstrated by the following: a. Three wet pull-ups, used wipes, and crumbled toilet paper was observed on the floor of the two-year old & three- year old bathroom at approximately 10:00 am on 02/27/2024. b. The inspector additionally observed a dry pull up, package of wipes, toilet plunger, toilet brush cleaner and a small toy were also lying on the floor near the toilet and children's hand washing sink in this bathroom. The placement of these items is a trip hazard as they are in space utilized for access to both the toilet and sink. c. The staff in the two-year old classroom, three-year old classroom and the program director all stated they were not aware that the wet pull-ups, wipes, toilet paper and other items had been left on the floor of the bathroom. 2. There are three exposed tree roots, beside the side walk , on the infant/toddler playground. These exposed tree roots are a trip hazard.”

8VAC20-780-290-A-3

“Based on observation, the center failed to ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: 1. One outlet in the three-year old classroom, near the large motor area, lacked a protective cover. 2. Three outlets in the two-year old class, near the bathroom, back door and front door, lacked a protective cover. 3. One outlet in the toddler classroom, near the back door, lacked a protective cover.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that when diapering of children disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot -operated and that the diapering surface shall be sanitized after each use for diapering. "Sanitized" means the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions. Evidence: 1. The surface of the diaper changing table, in the two-year old classroom, was not allowed to air dry after two diaper changes on 02/27/2024 at approximately 10:10 am. a. The surface was immediately wiped with a wet wipe after the disinfectant was sprayed. 2. Three wet disposable pull-ups were observed on the floor of the bathroom located between the two-year old and three-year old classroom on 02/27/2024 at approximately 10:00 am.”

8VAC20-780-570-C

“Based on record review and interview, the center failed to ensure that the record of each child on formula shall contain the brand of formula and the child's feeding schedule. Evidence: 1. Written documentation of the brand of formula and feeding schedule was not available for child 1, child 2 and child 3. a. Child 1, 2 and 3 were in care during the inspection on 02/27/2023 and are bottle fed. 2. Infant staff confirmed that a written feeding schedule and brand of formula was not on file.”

8VAC20-780-580-B

“Based on observation and interview, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the safety standards set by the Department of Motor Vehicles. Evidence: 1. The facility bus used to drop off and pick up children from public school lacked a current vehicle registration. The sticker on the attached license plates indicated the registration expired August 2023. 2. The program director stated she did not have a current registration sticker or certificate for the facility bus in use during the inspection on 02/27/2024 and 03/01/2024.”

8VAC20-820-120-E-6

“Based on observation, the center failed to ensure that a copy of any special order issued by the department shall be posted in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The special order issued on 11/16/2023 was not posted in a prominent place at each public entrance of the licensed premises on 02/27/2024. 2. The program director confirmed that the special order issued on 11/16/2023 was not posted.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to obtain a central registry finding within 30 days of employment for staff. Evidence: 1. Staff 2, hire date 11/13/2023, lacks the results of a central registry finding. a. Written documentation provided indicated that the request had been returned to the facility on 01/22/2024 for additional information. b. There was no documentation that the request had been re-submitted. 2. The program director stated she was not aware that the central registry finding was not on file nor was she aware that the request had been returned for additional information until she pulled the file for review by the inspector on 02/27/2024.”

22.1-289.011-F

“Based on observation and interview, the center failed to ensure that the findings of the most recent inspection shall be posted in a conspicuous place on the licensed premises. Evidence: 1. The findings from the most recent inspection, conducted on 09/05/2023, were not posted. a. The findings from the 07/23/2023 were posted. 2. The program director confirmed that the findings from the 09/05/2023 monitoring inspection were not posted.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment. Evidence: 1. Staff 3, hire date 01/02/2024, does not have documentation of a tuberculosis screening. a. Staff 3 was present and working during the inspection. 2. Staff 4, hire date 01/15/2024, does not have documentation of a tuberculosis screening. 3. The program director confirmed that documentation of a TB screening was not available for staff 3 and staff 4.”

8VAC20-780-550-P Complaint related: Yes

“Based on record review, the center failed to ensure that the written record of children's serious injuries in which entries are made the day of occurrence lacked all of the required elements. Evidence: 1. A review of more than 100 injury reports from 12/02/2023 through 03/17/2024 found the following required documentation lacking in written injury reports: a. 27 lacked either a parent or second staff signature; b. 69 lacked documentation of the time and method of parent notification; c. 16 lacked documentation or a staff and parent signature or 2 staff signatures; d. All of the injury reports reviewed lacked any documentation of how to prevent recurrence of the injury.”

8VAC20-780-340-A Complaint related: Yes

“Based on staff interviews, observations and a review of center video and injury reports, the center failed to ensure the care and protection of children. Evidence: 1. A review of injury reports for the two-year old classroom indicated approximately 122 injuries from approximately 12/02/2023 - 03/12/2024. a. 60 of these injuries were of children being bitten by another child; b. 39 of these injuries were of children being scratched, pushed or hit by toys thrown by another child. 2. Center staff interviewed, staff 1, staff 2, staff 3 and staff 4 described the two-year old classroom as "lacking structure," "chaotic," and difficult to manage. a. Staff additionally indicated that they did not feel they had the training or skills needed to manage children's behavior challenges especially biting. b. Staff also stated there were multiple children in the classroom with identified behavior challenges nevertheless, they had not received any training specific to these children or been apprised of any plan in place to address the behavior challenges. 3. A review of center video in the two-year old classroom, from approximately 8:10 am - 8:20 am on 03/08/2024, showed multiple incidents of children being injured by other children. a. One child was observed throwing toys while a second child hit another child. b. The video also showed ten children roaming around the room, climbing over overturned chairs, and attempting to climb up the diaper changing table while the two staff responsible for supervising the classroom of twelve children were occupied as they were assisting the other two children during this time. c. The lack of available activities and supervision for the ten children, resulted in the children occupying themselves in activities that increased the risk of injury. 4. During a classroom observation on 03/15/2024 child 1, who has been identified by all staff in addition to written records as having behavior challenges, bit another child while playing by the cots at approximately 11:10 am. a. During a planned activity, child 1 was not being supervised closely by staff which resulted in a "crowding" situation near the cots where child 1 was able to bite child 2.”

8VAC20-780-240-A

“Based on record review and interview, the center failed to ensure that staff complete The Virginia Department of Education-sponsored orientation course within 90 calendar days of employment. 1. Staff 2, hire date 11/13/2023, lacks documentation of completion of The Virginia Department of Education sponsored orientation course. 2. The program director confirmed that a certificate was not on file to demonstrate that staff 2 had completed this training.”

8VAC20-780-90-A

“Based on record review and interview, the center failed to ensure that a written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent and shall include authorization for emergency medical care, pick up of ill child and notification of communicable disease. Evidence: 1. The written parent agreement was not on file in the enrollment record of child 4. 2. The program director confirmed that a parent agreement was not on file for child 4.”

8VAC20-780-70

“Based on record review and interview, the center failed to ensure that staff records contain all required elements: Evidence: 1. The record for staff 1, hire date 04/17/2023, lacked the following required information: a. The name, address and phone number of a person to be notified in an emergency; b. Documentation that two or more references as to character and reputation as well as competency were checked before employment. c. Staff 1 was present and working in the facility during the inspection. 2. The record for staff 2, hire date 11/13/2023, lacked documentation of orientation training required by 8VAC20-780-240.B . 3. The record for staff 3, hire date 01/02/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. a. The name, address and telephone number of a person to be notified in an emergency was not on file for staff 3. b. Documentation to demonstrate that staff 3 possesses the education required by her job title of program leader was not on file. c. Staff 3 was present and working in the facility during the inspection. 4. The record for staff 4, hire date 01/15/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. 5. The program director confirmed that the above documents/documentation was not on file.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure that children's records contain all required documents. Evidence: 1. The enrollment record for child 1 lacked the following required information: a. Phone number for child's physician; b. An address for the second emergency contact. 2. The enrollment record for child 2 lacked the registration form containing all required elements. a. The program director confirmed that a completed enrollment form was not available for child 2. b. The program director stated that child 2 had an enrollment date of 08/03/2023. 3. The enrollment record for child 3 lacked the following required information: a. The work phone number for each parent's place of employment; b. An address and phone number for the second designated emergency contact. 4. The enrollment record for child 4, enrollment date 08/05/2021, lacked documentation of verification of age and identity. 5. The program director (staff 1 )confirmed the above documentation was missing from the records of child 1, 2 , 3 and 4.”

8VAC20-780-40-M

“Based on classroom review and interview, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list shall be dated and kept confidential in each room or area where children are present. Evidence: 1. The list of all children's allergies, sensitivities, and dietary restrictions was not maintained in the three-year old classroom. a. The allergy list in the classroom listed, "none" however, there are children in attendance, in other classrooms, with allergies, sensitivities and dietary restrictions. 2. The allergy list in the four-year old classroom only listed allergies, sensitivities, and dietary restrictions for children in attendance for the four-year old class. 3. The program director verified that classroom allergy lists only noted allergies, sensitivities and dietary restrictions for children in the individual class rather then the entire school.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 5, enrollment date 09/25/2023, lacked documentation of the required physical exam. 2. The program director confirmed that a physical exam was not on file for child 5.”

8VAC20-780-130-A

“Based on record review and interview, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Child 5, enrollment date 09/25/2023, did not have documentation of immunizations required by the State Board of Health. a. Child 5 was in care during the inspection. 2. The program director confirmed that an immunization record was not on file for child 5.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean and safe condition. Evidence: 1. The bathroom between the two-year old classroom and three-year old classroom was not maintained in a clean and safe condition as demonstrated by the following: a. Three wet pull-ups, used wipes, and crumbled toilet paper was observed on the floor of the two-year old & three- year old bathroom at approximately 10:00 am on 02/27/2024. b. The inspector additionally observed a dry pull up, package of wipes, toilet plunger, toilet brush cleaner and a small toy were also lying on the floor near the toilet and children's hand washing sink in this bathroom. The placement of these items is a trip hazard as they are in space utilized for access to both the toilet and sink. c. The staff in the two-year old classroom, three-year old classroom and the program director all stated they were not aware that the wet pull-ups, wipes, toilet paper and other items had been left on the floor of the bathroom. 2. There are three exposed tree roots, beside the side walk , on the infant/toddler playground. These exposed tree roots are a trip hazard.”

8VAC20-780-290-A-3

“Based on observation, the center failed to ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: 1. One outlet in the three-year old classroom, near the large motor area, lacked a protective cover. 2. Three outlets in the two-year old class, near the bathroom, back door and front door, lacked a protective cover. 3. One outlet in the toddler classroom, near the back door, lacked a protective cover.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that when diapering of children disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot -operated and that the diapering surface shall be sanitized after each use for diapering. "Sanitized" means the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions. Evidence: 1. The surface of the diaper changing table, in the two-year old classroom, was not allowed to air dry after two diaper changes on 02/27/2024 at approximately 10:10 am. a. The surface was immediately wiped with a wet wipe after the disinfectant was sprayed. 2. Three wet disposable pull-ups were observed on the floor of the bathroom located between the two-year old and three-year old classroom on 02/27/2024 at approximately 10:00 am.”

8VAC20-780-570-C

“Based on record review and interview, the center failed to ensure that the record of each child on formula shall contain the brand of formula and the child's feeding schedule. Evidence: 1. Written documentation of the brand of formula and feeding schedule was not available for child 1, child 2 and child 3. a. Child 1, 2 and 3 were in care during the inspection on 02/27/2023 and are bottle fed. 2. Infant staff confirmed that a written feeding schedule and brand of formula was not on file.”

8VAC20-780-580-B

“Based on observation and interview, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the safety standards set by the Department of Motor Vehicles. Evidence: 1. The facility bus used to drop off and pick up children from public school lacked a current vehicle registration. The sticker on the attached license plates indicated the registration expired August 2023. 2. The program director stated she did not have a current registration sticker or certificate for the facility bus in use during the inspection on 02/27/2024 and 03/01/2024.”

8VAC20-820-120-E-6

“Based on observation, the center failed to ensure that a copy of any special order issued by the department shall be posted in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The special order issued on 11/16/2023 was not posted in a prominent place at each public entrance of the licensed premises on 02/27/2024. 2. The program director confirmed that the special order issued on 11/16/2023 was not posted.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to obtain a central registry finding within 30 days of employment for staff. Evidence: 1. Staff 2, hire date 11/13/2023, lacks the results of a central registry finding. a. Written documentation provided indicated that the request had been returned to the facility on 01/22/2024 for additional information. b. There was no documentation that the request had been re-submitted. 2. The program director stated she was not aware that the central registry finding was not on file nor was she aware that the request had been returned for additional information until she pulled the file for review by the inspector on 02/27/2024.”

22.1-289.011-F

“Based on observation and interview, the center failed to ensure that the findings of the most recent inspection shall be posted in a conspicuous place on the licensed premises. Evidence: 1. The findings from the most recent inspection, conducted on 09/05/2023, were not posted. a. The findings from the 07/23/2023 were posted. 2. The program director confirmed that the findings from the 09/05/2023 monitoring inspection were not posted.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment. Evidence: 1. Staff 3, hire date 01/02/2024, does not have documentation of a tuberculosis screening. a. Staff 3 was present and working during the inspection. 2. Staff 4, hire date 01/15/2024, does not have documentation of a tuberculosis screening. 3. The program director confirmed that documentation of a TB screening was not available for staff 3 and staff 4.”

8VAC20-780-550-P Complaint related: Yes

“Based on record review, the center failed to ensure that the written record of children's serious injuries in which entries are made the day of occurrence lacked all of the required elements. Evidence: 1. A review of more than 100 injury reports from 12/02/2023 through 03/17/2024 found the following required documentation lacking in written injury reports: a. 27 lacked either a parent or second staff signature; b. 69 lacked documentation of the time and method of parent notification; c. 16 lacked documentation or a staff and parent signature or 2 staff signatures; d. All of the injury reports reviewed lacked any documentation of how to prevent recurrence of the injury.”

8VAC20-780-340-A Complaint related: Yes

“Based on staff interviews, observations and a review of center video and injury reports, the center failed to ensure the care and protection of children. Evidence: 1. A review of injury reports for the two-year old classroom indicated approximately 122 injuries from approximately 12/02/2023 - 03/12/2024. a. 60 of these injuries were of children being bitten by another child; b. 39 of these injuries were of children being scratched, pushed or hit by toys thrown by another child. 2. Center staff interviewed, staff 1, staff 2, staff 3 and staff 4 described the two-year old classroom as "lacking structure," "chaotic," and difficult to manage. a. Staff additionally indicated that they did not feel they had the training or skills needed to manage children's behavior challenges especially biting. b. Staff also stated there were multiple children in the classroom with identified behavior challenges nevertheless, they had not received any training specific to these children or been apprised of any plan in place to address the behavior challenges. 3. A review of center video in the two-year old classroom, from approximately 8:10 am - 8:20 am on 03/08/2024, showed multiple incidents of children being injured by other children. a. One child was observed throwing toys while a second child hit another child. b. The video also showed ten children roaming around the room, climbing over overturned chairs, and attempting to climb up the diaper changing table while the two staff responsible for supervising the classroom of twelve children were occupied as they were assisting the other two children during this time. c. The lack of available activities and supervision for the ten children, resulted in the children occupying themselves in activities that increased the risk of injury. 4. During a classroom observation on 03/15/2024 child 1, who has been identified by all staff in addition to written records as having behavior challenges, bit another child while playing by the cots at approximately 11:10 am. a. During a planned activity, child 1 was not being supervised closely by staff which resulted in a "crowding" situation near the cots where child 1 was able to bite child 2.”

8VAC20-780-240-A

“Based on record review and interview, the center failed to ensure that staff complete The Virginia Department of Education-sponsored orientation course within 90 calendar days of employment. 1. Staff 2, hire date 11/13/2023, lacks documentation of completion of The Virginia Department of Education sponsored orientation course. 2. The program director confirmed that a certificate was not on file to demonstrate that staff 2 had completed this training.”

8VAC20-780-90-A

“Based on record review and interview, the center failed to ensure that a written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent and shall include authorization for emergency medical care, pick up of ill child and notification of communicable disease. Evidence: 1. The written parent agreement was not on file in the enrollment record of child 4. 2. The program director confirmed that a parent agreement was not on file for child 4.”

8VAC20-780-70

“Based on record review and interview, the center failed to ensure that staff records contain all required elements: Evidence: 1. The record for staff 1, hire date 04/17/2023, lacked the following required information: a. The name, address and phone number of a person to be notified in an emergency; b. Documentation that two or more references as to character and reputation as well as competency were checked before employment. c. Staff 1 was present and working in the facility during the inspection. 2. The record for staff 2, hire date 11/13/2023, lacked documentation of orientation training required by 8VAC20-780-240.B . 3. The record for staff 3, hire date 01/02/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. a. The name, address and telephone number of a person to be notified in an emergency was not on file for staff 3. b. Documentation to demonstrate that staff 3 possesses the education required by her job title of program leader was not on file. c. Staff 3 was present and working in the facility during the inspection. 4. The record for staff 4, hire date 01/15/2024, lacked documentation of orientation training required by 8VAC20-780-240.B. 5. The program director confirmed that the above documents/documentation was not on file.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure that children's records contain all required documents. Evidence: 1. The enrollment record for child 1 lacked the following required information: a. Phone number for child's physician; b. An address for the second emergency contact. 2. The enrollment record for child 2 lacked the registration form containing all required elements. a. The program director confirmed that a completed enrollment form was not available for child 2. b. The program director stated that child 2 had an enrollment date of 08/03/2023. 3. The enrollment record for child 3 lacked the following required information: a. The work phone number for each parent's place of employment; b. An address and phone number for the second designated emergency contact. 4. The enrollment record for child 4, enrollment date 08/05/2021, lacked documentation of verification of age and identity. 5. The program director (staff 1 )confirmed the above documentation was missing from the records of child 1, 2 , 3 and 4.”

8VAC20-780-40-M

“Based on classroom review and interview, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list shall be dated and kept confidential in each room or area where children are present. Evidence: 1. The list of all children's allergies, sensitivities, and dietary restrictions was not maintained in the three-year old classroom. a. The allergy list in the classroom listed, "none" however, there are children in attendance, in other classrooms, with allergies, sensitivities and dietary restrictions. 2. The allergy list in the four-year old classroom only listed allergies, sensitivities, and dietary restrictions for children in attendance for the four-year old class. 3. The program director verified that classroom allergy lists only noted allergies, sensitivities and dietary restrictions for children in the individual class rather then the entire school.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 5, enrollment date 09/25/2023, lacked documentation of the required physical exam. 2. The program director confirmed that a physical exam was not on file for child 5.”

8VAC20-780-130-A

“Based on record review and interview, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Child 5, enrollment date 09/25/2023, did not have documentation of immunizations required by the State Board of Health. a. Child 5 was in care during the inspection. 2. The program director confirmed that an immunization record was not on file for child 5.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean and safe condition. Evidence: 1. The bathroom between the two-year old classroom and three-year old classroom was not maintained in a clean and safe condition as demonstrated by the following: a. Three wet pull-ups, used wipes, and crumbled toilet paper was observed on the floor of the two-year old & three- year old bathroom at approximately 10:00 am on 02/27/2024. b. The inspector additionally observed a dry pull up, package of wipes, toilet plunger, toilet brush cleaner and a small toy were also lying on the floor near the toilet and children's hand washing sink in this bathroom. The placement of these items is a trip hazard as they are in space utilized for access to both the toilet and sink. c. The staff in the two-year old classroom, three-year old classroom and the program director all stated they were not aware that the wet pull-ups, wipes, toilet paper and other items had been left on the floor of the bathroom. 2. There are three exposed tree roots, beside the side walk , on the infant/toddler playground. These exposed tree roots are a trip hazard.”

8VAC20-780-290-A-3

“Based on observation, the center failed to ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: 1. One outlet in the three-year old classroom, near the large motor area, lacked a protective cover. 2. Three outlets in the two-year old class, near the bathroom, back door and front door, lacked a protective cover. 3. One outlet in the toddler classroom, near the back door, lacked a protective cover.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that when diapering of children disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot -operated and that the diapering surface shall be sanitized after each use for diapering. "Sanitized" means the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions. Evidence: 1. The surface of the diaper changing table, in the two-year old classroom, was not allowed to air dry after two diaper changes on 02/27/2024 at approximately 10:10 am. a. The surface was immediately wiped with a wet wipe after the disinfectant was sprayed. 2. Three wet disposable pull-ups were observed on the floor of the bathroom located between the two-year old and three-year old classroom on 02/27/2024 at approximately 10:00 am.”

8VAC20-780-570-C

“Based on record review and interview, the center failed to ensure that the record of each child on formula shall contain the brand of formula and the child's feeding schedule. Evidence: 1. Written documentation of the brand of formula and feeding schedule was not available for child 1, child 2 and child 3. a. Child 1, 2 and 3 were in care during the inspection on 02/27/2023 and are bottle fed. 2. Infant staff confirmed that a written feeding schedule and brand of formula was not on file.”

8VAC20-780-580-B

“Based on observation and interview, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the safety standards set by the Department of Motor Vehicles. Evidence: 1. The facility bus used to drop off and pick up children from public school lacked a current vehicle registration. The sticker on the attached license plates indicated the registration expired August 2023. 2. The program director stated she did not have a current registration sticker or certificate for the facility bus in use during the inspection on 02/27/2024 and 03/01/2024.”

8VAC20-820-120-E-6

“Based on observation, the center failed to ensure that a copy of any special order issued by the department shall be posted in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The special order issued on 11/16/2023 was not posted in a prominent place at each public entrance of the licensed premises on 02/27/2024. 2. The program director confirmed that the special order issued on 11/16/2023 was not posted.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to obtain a central registry finding within 30 days of employment for staff. Evidence: 1. Staff 2, hire date 11/13/2023, lacks the results of a central registry finding. a. Written documentation provided indicated that the request had been returned to the facility on 01/22/2024 for additional information. b. There was no documentation that the request had been re-submitted. 2. The program director stated she was not aware that the central registry finding was not on file nor was she aware that the request had been returned for additional information until she pulled the file for review by the inspector on 02/27/2024.”

22.1-289.011-F

“Based on observation and interview, the center failed to ensure that the findings of the most recent inspection shall be posted in a conspicuous place on the licensed premises. Evidence: 1. The findings from the most recent inspection, conducted on 09/05/2023, were not posted. a. The findings from the 07/23/2023 were posted. 2. The program director confirmed that the findings from the 09/05/2023 monitoring inspection were not posted.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment. Evidence: 1. Staff 3, hire date 01/02/2024, does not have documentation of a tuberculosis screening. a. Staff 3 was present and working during the inspection. 2. Staff 4, hire date 01/15/2024, does not have documentation of a tuberculosis screening. 3. The program director confirmed that documentation of a TB screening was not available for staff 3 and staff 4.”

8VAC20-780-280-B

“Based on observation the center did not ensure all hazardous substances were shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: On top of the school-age cubbies there was a large container of dish soap, in reach of children in care.”

8VAC20-780-330-B

“(Repeat Violation) Based on observation the center did not ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99. Evidence: 1. The 2 composite play structures on the playground did not have the required resilient surfacing. On the preschool playground there was a composite structure that had about 4 inches of mulch in the fall zones, were 6 inches is required. Grass and vegetation was observed growing in the fall zone areas of this piece of equipment.”

8VAC20-780-500-B

“Based on observation the center did not ensure all diapering surfaces are tol be used only for diapering. Evidence: In the toddler room there was a clipboard and a water bottle being stored on the changing table.”

8VAC20-780-40-E Complaint related: Yes

“Based upon staff interview, the facility has not ensured that the operational responsibilities of the licensee include ensuring that the center's activities are maintained in compliance with the center's own policies and procedures regarding consistency of care. Evidence: The facility's written policy regarding consistency of care/primary caregiving indicates that children "will be assigned a primary caregiver" so a child is able "to form an immediate and stable relationship with a caregiver". a. Interviews of staff revealed that the three staff persons (staff 1, 2 and 3) on duty during the day in the two year old classroom were in their third week of working together in the classroom during the week of May 22, 2023 - May 26, 2023. Staff stated that the children were not clearly divided into groups (with a primary caregiver) until the week of May 29, 2023. b. Staff stated that staff 4, program leader of the two year old classroom, had been moved to another classroom, after which the staff in the two year old classroom had not been assigned primary caregiver roles.”

8VAC20-780-40-E

“Based on interviews and a record review the center did not ensure the center's activities were maintained in compliance with these standards and the center's own policies and procedures that are required by these standards. Evidence: 1. As part of the center's supervision policy staff are required to complete a "face-to-name" check of the children in their care on an hourly basis and before and after transitioning children from one area of the center to another. Staff are required to see he child's face and say their name to confirm all children are accounted for followed by marking it on a "face-to-name" sheet. 2. On 05/16/2023 Staff #1 and #2 took 4 toddlers to the playground and returned back to the classroom with only 3 children. The director confirmed all 4 children were marked as accounted for, however neither staff performed an actual face-to-name check of the children when they came back to the classroom.”

8VAC20-780-340-A

“Based on observation the center did not ensure when staff are supervising children they shall always ensure their care, protection and guidance. Evidence: 1. On 05/16/2023, The center did not ensure the care, protection and guidance of child #1 when he was left on the playground for approximately 15 minutes and not discovered until the child's parents arrived to pick him up. 2. Staff reported child #1 was found outside tapping on the outside door to his classroom and crying. Staff described him as visibly "upset."”

8VAC20-780-340-F

“Based on interviews the center did not ensure children under 10 years of age were always within sight and sound supervision of staff. Evidence: 1. Center staff reported to the licensing office that Child #1 was left alone and unsupervised on the playground on the afternoon of 05/16/2023. 2. Staff #1 and #2 were out on the playground supervising 8 children from the toddler room and they returned to the classroom at approximately 4:40pm. At approximately 4:57pm the parent of Child #1 came to pick them up, and Child #1 was not in their classroom. Child #1 was then found by the director alone and unsupervised on the playground.”

8VAC20-780-330-B

“Based on observation the center did not ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99. Evidence: 1. The 2 composite play structures on the playground did not have the required resilient surfacing. a. There was approximately 2 inches of mulch in the fall zones, were 6 inches is required. b. Grass and vegetation was observed growing in the fall zone areas of both pieces of equipment. c. The preschool play structure had a large root exposed at the base of the slide.”

8VAC20-780-40-E Complaint related: Yes

“Based upon staff interview, the facility has not ensured that the operational responsibilities of the licensee include ensuring that the center's activities are maintained in compliance with the center's own policies and procedures regarding consistency of care. Evidence: The facility's written policy regarding consistency of care/primary caregiving indicates that children "will be assigned a primary caregiver" so a child is able "to form an immediate and stable relationship with a caregiver". a. Interviews of staff revealed that the three staff persons (staff 1, 2 and 3) on duty during the day in the two year old classroom were in their third week of working together in the classroom during the week of May 22, 2023 - May 26, 2023. Staff stated that the children were not clearly divided into groups (with a primary caregiver) until the week of May 29, 2023. b. Staff stated that staff 4, program leader of the two year old classroom, had been moved to another classroom, after which the staff in the two year old classroom had not been assigned primary caregiver roles.”

8VAC20-780-40-E

“Based on interviews and a record review the center did not ensure the center's activities were maintained in compliance with these standards and the center's own policies and procedures that are required by these standards. Evidence: 1. As part of the center's supervision policy staff are required to complete a "face-to-name" check of the children in their care on an hourly basis and before and after transitioning children from one area of the center to another. Staff are required to see he child's face and say their name to confirm all children are accounted for followed by marking it on a "face-to-name" sheet. 2. On 05/16/2023 Staff #1 and #2 took 4 toddlers to the playground and returned back to the classroom with only 3 children. The director confirmed all 4 children were marked as accounted for, however neither staff performed an actual face-to-name check of the children when they came back to the classroom.”

8VAC20-780-340-A

“Based on observation the center did not ensure when staff are supervising children they shall always ensure their care, protection and guidance. Evidence: 1. On 05/16/2023, The center did not ensure the care, protection and guidance of child #1 when he was left on the playground for approximately 15 minutes and not discovered until the child's parents arrived to pick him up. 2. Staff reported child #1 was found outside tapping on the outside door to his classroom and crying. Staff described him as visibly "upset."”

8VAC20-780-340-F

“Based on interviews the center did not ensure children under 10 years of age were always within sight and sound supervision of staff. Evidence: 1. Center staff reported to the licensing office that Child #1 was left alone and unsupervised on the playground on the afternoon of 05/16/2023. 2. Staff #1 and #2 were out on the playground supervising 8 children from the toddler room and they returned to the classroom at approximately 4:40pm. At approximately 4:57pm the parent of Child #1 came to pick them up, and Child #1 was not in their classroom. Child #1 was then found by the director alone and unsupervised on the playground.”

8VAC20-780-330-B

“Based on observation the center did not ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99. Evidence: 1. The 2 composite play structures on the playground did not have the required resilient surfacing. a. There was approximately 2 inches of mulch in the fall zones, were 6 inches is required. b. Grass and vegetation was observed growing in the fall zone areas of both pieces of equipment. c. The preschool play structure had a large root exposed at the base of the slide.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: Grass was observed growing in the mulch in all areas of the fall zone surrounding the preschool and toddler outdoor play structure.”

8VAC20-780-550-D

“Based on record review and interview the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency log for the facility did not list a practice drill for July and August of 2022. a. Administrative staff verified that a fire drill had not been conducted in July and August of 2022.”

8VAC20-780-560-F

“Based on observation, the center failed to ensure that a menu listing foods to be served for meals and snacks during the current one-week period shall be posted in a location conspicuous to parents. Evidence: 1. The current menu, for the week beginning 11/07/2022, was not posted. a. The menu for the week beginning 10/24/2022 was posted outside of the kitchen. b. The menu for the week beginning 10/31/2022 was posted in the lobby area of the facility.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Documentation of current immunizations was not on file for child 1. a. Child 1 has an enrollment date of 11/01/2022.”

22.1-289.035-B-4

“Based on record review and interview, the center failed to obtain a copy of the results of a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. The results of a central registry check from a state that staff 1 has resided in within the past five years was not on file. a. Staff 1 has a hire date of 11/22/2021. 2. Administrative staff confirmed that the results of this central registry check were not on file.”

8VAC20-780-130-E

“Based on record review, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations for child 2 were administered on 05/01/2021 according to the immunization record on file. a. Child 2 is under the age of two years.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. The soil had eroded away from an area of sidewalk on the toddler playground. This has resulted in four exposed tree roots and a drop off from the sidewalk to the ground that is a trip hazard. 2. Two areas of sheet vinyl flooring, measuring approximately 3 inches, have ripped apart at the floor drain in the four-year old bathroom.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. Cleaning agents were observed stored in an unlocked cabinet on the wall about the diapering table in the two-year old classroom. 2. A spray bottle of disinfectant was observed on the diaper changing table in the toddler classroom. a. Staff confirmed they had failed to lock the disinfectant in the cabinet after completion of diaper changing.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records have all of the required elements. Evidence: 1. The enrollment record for child 1 lacked documentation of viewing proof of the child's age and identity. a. Administrative staff stated the birth certificate had been viewed for child 1 however, written verification had not been noted in the child's record. 3. A written care plan, from a physician, was not on file for child 3. Child 3 has a diagnosed food allergy according to written information in the enrollment record. a. Administrative staff confirmed that a written allergy care plan had not been obtained for child 3.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: Grass was observed growing in the mulch in all areas of the fall zone surrounding the preschool and toddler outdoor play structure.”

8VAC20-780-550-D

“Based on record review and interview the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency log for the facility did not list a practice drill for July and August of 2022. a. Administrative staff verified that a fire drill had not been conducted in July and August of 2022.”

8VAC20-780-560-F

“Based on observation, the center failed to ensure that a menu listing foods to be served for meals and snacks during the current one-week period shall be posted in a location conspicuous to parents. Evidence: 1. The current menu, for the week beginning 11/07/2022, was not posted. a. The menu for the week beginning 10/24/2022 was posted outside of the kitchen. b. The menu for the week beginning 10/31/2022 was posted in the lobby area of the facility.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Documentation of current immunizations was not on file for child 1. a. Child 1 has an enrollment date of 11/01/2022.”

22.1-289.035-B-4

“Based on record review and interview, the center failed to obtain a copy of the results of a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. The results of a central registry check from a state that staff 1 has resided in within the past five years was not on file. a. Staff 1 has a hire date of 11/22/2021. 2. Administrative staff confirmed that the results of this central registry check were not on file.”

8VAC20-780-130-E

“Based on record review, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations for child 2 were administered on 05/01/2021 according to the immunization record on file. a. Child 2 is under the age of two years.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. The soil had eroded away from an area of sidewalk on the toddler playground. This has resulted in four exposed tree roots and a drop off from the sidewalk to the ground that is a trip hazard. 2. Two areas of sheet vinyl flooring, measuring approximately 3 inches, have ripped apart at the floor drain in the four-year old bathroom.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. Cleaning agents were observed stored in an unlocked cabinet on the wall about the diapering table in the two-year old classroom. 2. A spray bottle of disinfectant was observed on the diaper changing table in the toddler classroom. a. Staff confirmed they had failed to lock the disinfectant in the cabinet after completion of diaper changing.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records have all of the required elements. Evidence: 1. The enrollment record for child 1 lacked documentation of viewing proof of the child's age and identity. a. Administrative staff stated the birth certificate had been viewed for child 1 however, written verification had not been noted in the child's record. 3. A written care plan, from a physician, was not on file for child 3. Child 3 has a diagnosed food allergy according to written information in the enrollment record. a. Administrative staff confirmed that a written allergy care plan had not been obtained for child 3.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: Grass was observed growing in the mulch in all areas of the fall zone surrounding the preschool and toddler outdoor play structure.”

8VAC20-780-550-D

“Based on record review and interview the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency log for the facility did not list a practice drill for July and August of 2022. a. Administrative staff verified that a fire drill had not been conducted in July and August of 2022.”

8VAC20-780-560-F

“Based on observation, the center failed to ensure that a menu listing foods to be served for meals and snacks during the current one-week period shall be posted in a location conspicuous to parents. Evidence: 1. The current menu, for the week beginning 11/07/2022, was not posted. a. The menu for the week beginning 10/24/2022 was posted outside of the kitchen. b. The menu for the week beginning 10/31/2022 was posted in the lobby area of the facility.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Documentation of current immunizations was not on file for child 1. a. Child 1 has an enrollment date of 11/01/2022.”

22.1-289.035-B-4

“Based on record review and interview, the center failed to obtain a copy of the results of a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. The results of a central registry check from a state that staff 1 has resided in within the past five years was not on file. a. Staff 1 has a hire date of 11/22/2021. 2. Administrative staff confirmed that the results of this central registry check were not on file.”

8VAC20-780-130-E

“Based on record review, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations for child 2 were administered on 05/01/2021 according to the immunization record on file. a. Child 2 is under the age of two years.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. The soil had eroded away from an area of sidewalk on the toddler playground. This has resulted in four exposed tree roots and a drop off from the sidewalk to the ground that is a trip hazard. 2. Two areas of sheet vinyl flooring, measuring approximately 3 inches, have ripped apart at the floor drain in the four-year old bathroom.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. Cleaning agents were observed stored in an unlocked cabinet on the wall about the diapering table in the two-year old classroom. 2. A spray bottle of disinfectant was observed on the diaper changing table in the toddler classroom. a. Staff confirmed they had failed to lock the disinfectant in the cabinet after completion of diaper changing.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records have all of the required elements. Evidence: 1. The enrollment record for child 1 lacked documentation of viewing proof of the child's age and identity. a. Administrative staff stated the birth certificate had been viewed for child 1 however, written verification had not been noted in the child's record. 3. A written care plan, from a physician, was not on file for child 3. Child 3 has a diagnosed food allergy according to written information in the enrollment record. a. Administrative staff confirmed that a written allergy care plan had not been obtained for child 3.”

8VAC20-780-340-A Complaint related: Yes

“Based on staff interviews and a review of center video, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. On 6/6/2022 at approximately 10:00 am, child 1 (10 months) sustained an injury to her mouth following actions taken by staff 1, who was supervising child 1 at the time. A review of center video shows the following: a. Child 1, age 10 months, crawls into the open doorway between the infant and toddler classroom. Three high chairs are placed in the area of the infant class directly in front of this doorway; b. Staff 1 picks up child 1 and holds the child briefly; c. Staff 1 then turns the child over, into a face down position, and places her on the floor under the high chairs; d. Staff 1 is seen leaning down and then child 1 is observed moving forward, with some force, under the high chair, then falling on her face. 2. Staff 2, who was in the infant classroom, stated she observed staff 1 pick up child 1 and place her on the floor, under the high chairs, and "push from behind" child 1. "She fell forward and got her face." "She cried as soon as her face hit the floor." Staff 2 reported that child 1's lips were bleeding as was the inside of her mouth. 3. Staff 3, who was in the infant classroom, reports she observed staff 1 pick up child 1, turn her around, and "slid her from behind." "She kneeled down and pushed underhanded by her bottom and child 1 fell face first on the floor." Staff 3 stated this fall resulted in bleeding around child 1's lip and mouth as her tooth hit her lips when she fell on her face. 4. Staff 4 stated that she observed staff 1 pick up child 1 and "put her on the floor in a crawl position facing the infant room." "Staff 1 placed child 1 under the high chair and pushed using her hand." This caused child 1 to "fall and bust her lip....and she was crying." 5. Staff 1 stated during interview that "I pick her up and put her under the high chairs." "I put her on her hands and knees and gave her a gentle push." "I gave a push to make her go back into the (infant) room as she had turned around and the high chairs were in the way." "She fell forward accidentally....she bit her lip and started crying." Staff 1 additionally stated, "I didn't push her hard....just a little tap." 6. Staff 2 and staff 3 stated that child 1 had good motor skills and is able to crawl with no problems.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: Grass was observed growing in the mulch in all areas of the fall zone surrounding the preschool outdoor play structure.”

8VAC20-780-130-E

“Based on record review, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations on file for child 2, age 9 months, were administered on 09/30/2021. 2. The most recent immunizations on file for child 3, age 9 months, were administered on 09/27/2021. 3. The most recent immunizations on file for child 4, age 19 months, were administered on 11/16/2020.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records have all of the required elements: Evidence: 1. The enrollment record for child 1 lacked the following required information: a. A second emergency contact; b. An address for the first emergency contact.”

8VAC20-780-510-G

“Based on medication review, the center failed to ensure that medication shall be labeled with the child's name. Evidence: 1. Two bottles of over-the-counter medication, for child 5 and child 6, were not labeled with the name of each child. a. Both medication's were in a labeled plastic bag.”

8VAC20-780-290-A-3

“Based on observation, the center failed to ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: One electrical outlet, near the home living play area in the 3's/4's classroom, lacked a protective cover.”

8VAC20-780-560-F

“Based on observation, the center failed to ensure that a menu listing foods to be served for meals and snacks during the current one-week period shall be posted in a location conspicuous to parents. Evidence: The current menu was not posted. The menu for the previous week, 05/02/2022 - 05/06/2022, was posted.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. Two bottles of disinfectant cleaning agents were observed in an unlocked cabinet in the 3's/4's classroom. 2. Three bottles of disinfectant cleaning agents were observed in an unlocked cabinet in the 2's classroom. a. Both cabinets were located higher up on the wall of these classrooms.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe condition. Evidence: 1. The cord from the temporary air conditioning unit, in the infant classroom, was dangling and accessible from the rear of the unit. 2. The soil has eroded away from an area of sidewalk on the toddler playground. This has resulted in multiple exposed tree roots and a drop off from the sidewalk to the ground that is a trip hazard. 3. One area of tree branch, from the pine tree on the toddler/two's playground, has grown downward toward the play structure. This branch protrudes outward and downward in such a way as to pose a risk to the upper body of any child or staff, over four feet in height, walking into this branch.”

8VAC20-790-600-D-2

“Based on record review, the vendor failed to ensure that staff obtain current certification in first aid appropriate to the ages of children in care within 90 days of employment. Evidence: 1. Staff 1, hire date 09/02/2021, does not have first aid certification.”

8VAC20-790-600-D-1

“Based on record review, the vendor failed to ensure that staff have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Evidence: 1. The CPR certification for staff 1, obtained on 02/15/2021, did not include an in-person competency demonstration.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: Grass was observed growing in the mulch in all areas of the fall zone surrounding the preschool outdoor play structure.”

8VAC20-780-130-E

“Based on record review, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations on file for child 2, age 9 months, were administered on 09/30/2021. 2. The most recent immunizations on file for child 3, age 9 months, were administered on 09/27/2021. 3. The most recent immunizations on file for child 4, age 19 months, were administered on 11/16/2020.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records have all of the required elements: Evidence: 1. The enrollment record for child 1 lacked the following required information: a. A second emergency contact; b. An address for the first emergency contact.”

8VAC20-780-510-G

“Based on medication review, the center failed to ensure that medication shall be labeled with the child's name. Evidence: 1. Two bottles of over-the-counter medication, for child 5 and child 6, were not labeled with the name of each child. a. Both medication's were in a labeled plastic bag.”

8VAC20-780-290-A-3

“Based on observation, the center failed to ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: One electrical outlet, near the home living play area in the 3's/4's classroom, lacked a protective cover.”

8VAC20-780-560-F

“Based on observation, the center failed to ensure that a menu listing foods to be served for meals and snacks during the current one-week period shall be posted in a location conspicuous to parents. Evidence: The current menu was not posted. The menu for the previous week, 05/02/2022 - 05/06/2022, was posted.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. Two bottles of disinfectant cleaning agents were observed in an unlocked cabinet in the 3's/4's classroom. 2. Three bottles of disinfectant cleaning agents were observed in an unlocked cabinet in the 2's classroom. a. Both cabinets were located higher up on the wall of these classrooms.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe condition. Evidence: 1. The cord from the temporary air conditioning unit, in the infant classroom, was dangling and accessible from the rear of the unit. 2. The soil has eroded away from an area of sidewalk on the toddler playground. This has resulted in multiple exposed tree roots and a drop off from the sidewalk to the ground that is a trip hazard. 3. One area of tree branch, from the pine tree on the toddler/two's playground, has grown downward toward the play structure. This branch protrudes outward and downward in such a way as to pose a risk to the upper body of any child or staff, over four feet in height, walking into this branch.”

8VAC20-790-600-D-2

“Based on record review, the vendor failed to ensure that staff obtain current certification in first aid appropriate to the ages of children in care within 90 days of employment. Evidence: 1. Staff 1, hire date 09/02/2021, does not have first aid certification.”

8VAC20-790-600-D-1

“Based on record review, the vendor failed to ensure that staff have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Evidence: 1. The CPR certification for staff 1, obtained on 02/15/2021, did not include an in-person competency demonstration.”

8VAC20-780-500-B Complaint related: Yes

“Based on record review and staff interviews, the center failed to ensure that when a child's clothing or diaper becomes wet or soiled, the child shall be cleaned and changed immediately. Evidence: 1. The parent of child 1 stated that her child, age 18 months, was in a wet and soiled diaper when she picked her up at 1:34 pm on 03/18/2022. The parent additionally stated that her child's bottom was red with a slight rash which required an over-the-counter ointment. a. The parent stated she had placed a clean huggies diaper on her child at approximately 8:25 am prior to drop off at the facility. b. The parent indicated she had received written documentation that her child had been changed at 9:36 am however, her child was in the same brand of diaper placed on her at approximately 8:25 am just prior to drop off at the facility. c. Staff 1, 2 and 3 confirmed that the facility provides a different brand of diaper than huggies. 2. Staff 1 indicated it was the policy of the school to check and/or change children's diapers every two hours. a. Staff 1 reviewed the diaper log which listed a diaper change for child 1 at 9:36 am and confirmed that child 1 should have had additional diaper changes. 3. Staff 2 and staff 3 stated it was the policy of the toddler classroom to check and/or change diapers every two hours. a. Staff 2 and staff 3 stated they thought child 1 was dry when they checked her at 9:36 am but most likely indicated she was wet by mistake. b. Staff 2 and staff 3 stated they could not recall changing child 1's diaper and indicated it was likely they had "skipped her" as it had been a busy day. c. Staff 2 and staff 3 confirmed they failed to follow center policy when the did not check and or change child 1's diaper every two hours.”

8VAC20-780-410-1 Complaint related: Yes

“Based on staff interviews, the center failed to ensure that the following actions are forbidden: roughly handling a child. Evidence: 1. It was reported by individual 1, who reviewed the center live video feed at 1:15 pm on 03/18/2022, that staff 4 was observed grabbing a two-year old child, child 2, from under his arm in a way described as "rough" and tossing the child onto a cot. 2. Individual 2 stated the following was observed on the same video feed: "I saw a child standing by his cot...the caregiver (staff 4) grabbed him forcefully and threw him on his cot." She (staff 4) grabbed the child under his arm using both of her hands." 3. Staff 1 who also reviewed the center video stated she observed staff 4 taking child 2 by the upper arm in a quick and sudden manner and forcing the child down to the floor into a seated position. a. Staff 1 stated the way in which staff 4 took hold of child 2's arm and pulled him down was a violation of center policy. 3. Staff 4 stated that child 2 had been running around the class and had run under the table where he hit his head. Staff 4 stated, "He came to me and I gave him a hug....He slapped me and I told him don't hit....I tried to push him away and he sat down next to me." a. Staff 4 also stated, "I don't think I would ever grab a child."”

8VAC20-780-400-B Complaint related: Yes

“Based on staff interviews, the center failed to ensure that behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. Two individuals reported that the center live video feed of the two-year old class, at approximately 1:15 pm on 03/18/2022, showed staff 4 offering no redirection or quite activities to child 2, who was running around the class during nap. a. Two individuals stated they observed staff 4 grab child 2 by the upper arm and toss him onto his cot rather than provide any type of redirection or activity. 2. Staff 1 also viewed the same video footage and confirmed that staff 4 failed to offer any quite activities or redirection when child 2 was running around the classroom. a. Staff 1 indicated that the video showed staff 4 grabbing child 2 by the arm and pulling him down to sit beside her instead of providing a quite activity or redirecting the child. b. Staff 1 stated center policy is for staff to redirect children to an appropriate quite activity during nap time. 3. Staff 4 stated she did not provide any redirection to child 2 beyond several verbal prompts for him to be quite and return to his cot.”

22VAC40-185-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: 1. The mulch under the outdoor preschool slide chute and tunnel chute has washed away leaving only dirt. 2. Grass was observed growing up in multiple areas of the mulch surrounding the fall zone of the outdoor preschool play structure. a. Grass compromises the impact absorbing ability of the mulch.”

22VAC40-185-510-N

“Based on medication review, the center failed to ensure that when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet. Evidence: 1. One over-the-counter medication, for child 1, had not been returned to the parent after the written authorization from the parent expired. 2. The written authorization expired on 10/18/2021 according to written medication forms on file.”

22VAC40-185-270-A

“Based on observation, the center failed to ensure that outside areas of the center shall be maintained in a safe condition. 1. Seven tree roots were observed protruding from the ground, surrounding the outdoor play structure, on the toddler/two-year old playground. a. These tree roots present a trip hazard.”

22VAC40-185-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Evidence: 1. The mulch under the outdoor preschool slide chute and tunnel chute has washed away leaving only dirt. 2. Grass was observed growing up in multiple areas of the mulch surrounding the fall zone of the outdoor preschool play structure. a. Grass compromises the impact absorbing ability of the mulch.”

22VAC40-185-510-N

“Based on medication review, the center failed to ensure that when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet. Evidence: 1. One over-the-counter medication, for child 1, had not been returned to the parent after the written authorization from the parent expired. 2. The written authorization expired on 10/18/2021 according to written medication forms on file.”

22VAC40-185-270-A

“Based on observation, the center failed to ensure that outside areas of the center shall be maintained in a safe condition. 1. Seven tree roots were observed protruding from the ground, surrounding the outdoor play structure, on the toddler/two-year old playground. a. These tree roots present a trip hazard.”